CMS/CDC Guidance on Staff and Resident Care during COVID-19 Crisis
Jeannine LeCompte, Compliance Research Specialist
The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) published guidelines to be followed by all long-term care facilities (LTCs) when dealing with staff and resident interaction, designed to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19).
To avoid transmission within LTCs, facilities should use separate staffing teams for COVID-19-positive residents to the best of their ability, and work with state and local leaders to designate separate facilities or units within a facility to separate COVID-19-negative residents from COVID-19-positive residents and individuals with unknown COVID-19 status.
LTCs should exercise to the extent possible consistent assignments (meaning the assignment of staff to certain patients and residents) for all patients and residents regardless of symptoms or COVID-19 status. This practice can enhance staff’s familiarity with their assigned patients and residents, helping them detect emerging condition changes that unfamiliar staff may not notice.
The goal is to decrease the number of different staff interacting with each patient and resident as well as the number of times those staff interact with the patient and resident. Also, staff as possible should not work across units or floors.
COVID-19-positive units and facilities must be capable of maintaining strict infection control practices and testing protocols, as required by regulation. There may be a need for some of these COVID-19-positive LTCs to have the capacity, staffing, and infrastructure to manage higher intensity patients, including ventilator management. To this end, state agencies including health departments, hospitals, and nursing home associations will have to ensure coordination among facilities to determine which facilities will have a designation, and to provide adequate staff supplies and personal protective equipment.
If possible, all admitted residents (including readmissions) should be isolated for 14 days if their COVID-19 status is unknown; and residents and their families must be informed to the fullest extent possible on limitations of their access to and ability to leave and re-enter the facility, as well as any requirements and procedures for placement in alternative facilities for COVID-19-positive or unknown status.
COVID-19 Long-Term Care Facility Guidance
https://www.cms.gov/files/document/4220-covid-19-long-term-care-facility-guidance.pdf
